black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

THOMAS WESLEY SAMSON

PRODUCER NON-RESIDENT

License Number:
PRN409772
Status:
First Licensure:
02/03/2022
Cancel Date:
None

Mailing:
HENDERSON, NV 89011
Phone:
+1 (866) 597-2424
Fax:
+1 (866) 445-4639
Email:
licensing@pethealthinc.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/03/2022

Agency

Name Issue Date License Number Expiration Date Cancel Date
PTZ INS AGENCY LTD
03/07/2022 AGN161448

Employer

Name Issue Date License Number Expiration Date Cancel Date
INDEPENDENCE AMERICAN INSURANCE COMPANY
09/11/2023 PCF86149
NORTH RIVER INSURANCE COMPANY
06/06/2023 PCF698
UNITED STATES FIRE INSURANCE COMPANY
06/06/2023 PCF101256

Authority

Description Issue Date Termination Date Status
CASUALTY 02/03/2022 Active
PROPERTY 02/03/2022 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20223290

Other Addresses

Address Type
HENDERSON, NV 89011
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/14/2025 05:58:20 AM